A multicenter study of CA 125 level as a predictor of non-optimal primary cytoreduction of advanced epithelial ovarian cancer

O. Gemer, M. Lurian, M. Gdalevich, V. Kapustian, E. Piura, D. Schneider, O. Lavie, T. Levy, A. Fishman, R. Dgani, H. Levavi, U. Beller

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41 Scopus citations

Abstract

Aims: To provide a large database of pre-operative CA 125 levels which may predict inappropriate cytoreductive surgery in patients with advanced epithelial ovarian cancer. Methods: A multicenter review of the records of 424 patients with FIGO stage III and IV epithelial ovarian cancer of patients who underwent primary cytoreductive surgery was performed. The validity of pre-operative CA 125 level measurement as a single predictor of the possibility to achieve only suboptimal cytoreduction was evaluated by calculating the sensitivity and the specificity of various cut-off values. The relative importance of different cut-off values in achieving the best predictive validity was assessed by a receiver operating characteristics (ROC) curve. Results: Optimal cytoreduction (largest diameter of residual tumour ≤1 cm) was achieved in 242 patients. The median CA 125 level in optimally cytoreduced patients was lower than in those patients suboptimally debulked (304 vs 863 U/mL; p<0.001). The area under the ROC curve was 0.65 (95% confidence interval, 0.60-0.71) and the CA 125 threshold derived from the ROC was 400 U/mL. The accuracy of the test at this level was 62%. Conclusions: The clinical applicability of the ROC derived CA 125 threshold is limited. The data accrued in the study provides a basis for decision-making regarding the place of primary surgery various CA 125 levels.

Original languageEnglish
Pages (from-to)1006-1010
Number of pages5
JournalEuropean Journal of Surgical Oncology
Volume31
Issue number9
DOIs
StatePublished - 1 Jan 2005

Keywords

  • CA 125
  • Cytoreduction
  • Epithelial ovarian cancer
  • Prediction

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